急性重症胆管炎患者胆汁中内皮素及降钙素基因相关肽的检测及意义

THE SIGNIFICANCE OF DETECTION OF ENDOTHELINS AND CALCITONIN GENE RELATED PROTEIN IN BILE IN PATIENTS WITH ACUTE CHOLANGITIS OF SEVERE TYPE

目的 :探讨急性重症胆管炎 (ACST)患者胆汁中内皮素 (ET)及降钙素基因相关肽 (CGRP)浓度变化及意义。方法 :采用放射免疫分析法检测了 5 5例ACST患者术中、术后 7天、术后 1 4天胆汁中ET及CGRP的浓度。结果 :ACST患者术中ET的浓度显著高于对照组 (P <0 .0 1～ 0 .0 0 1 ) ,病情严重程度不同的两组病例术中胆汁ET的浓度差异也有显著性 (P <0 .0 5 ) ,术后胆汁中ET的浓度逐渐下降 ;术中胆汁中CGRP的浓度显著低于对照组 (P <0 .0 1 ) ,术后胆汁中CGRP的浓度逐渐升高。结论 :ET参与了ACST肝胆系统的病理损害过程 ,胆汁中ET的浓度与ACST病情严重程度有关 ;胆汁中ET与CGRP二者间的平衡紊乱可能在ACST肝胆系统的病理损害过程中具有重要意义。

Objective:To study the change of concentration of endothelins (ET) and calcitonin gene related protein(CGRP) in bile in patients with acute cholangitis of severe type(ACST) and its significance. Methods: The concentration of the bile ET and CGRP was detected by radioimmunoassay in 55 cases of ACST during operation and 7-days and 14-days after operation. Results: Compared with the control group, the concentration of ET in bile in patients with ACST was significantly higher during operation (P<0.01～0.001). There was a significant concentration difierence in bile ET during operation between the ACST-Ⅰ and ACST-Ⅱ groups (P<0.05). The concentration of ET in bile gradually was reduced after operation in all cases of ACST but the concentration of bile CGRP, which had been decreased during operation, rose significantly after operation. Conclusions: The ET in bile has some effect on the ACST formation in the liver and bile ducts. The content of ET in bile is relative to the severeness of ACST. The disequilibrium between bile ET and CGRP may contribute to the pathologic process of liver and bile duct injury.